MEDICARE: MS. WENDY A WHITE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LCSW10664	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649372939
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. WENDY A WHITE LCSW

Provider Business Mailing Address
First Line	:	200 S PORTER AVE
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85710-4423
Country	:	US
Telephone Number	:	520-665-1990
Fax Number	:	520-568-5200

Provider Business Practice Location Address
First Line	:	1601 N TUCSON BLVD STE 36
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85716-3409
Country	:	US
Telephone Number	:	520-465-6465
Fax Number	:	520-568-5200

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2006
Last Update Date	:	06/02/2026

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